14-0122 (RPL)4.
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
14-00000122
Property Address:
52200 AVENIDA RUBIO
APN:
773-213-011-12 -000000-
Application description:
POOL - RESIDENTIAL
Property Zoning:
COVE RESIDENTIAL
Application valuation:
22000
Applicant: Architect or Engineer:
•4 f`e-iu
VOICE (760) 777-7012
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 2/10/14
Owner:
RICHARD STEINBAM/KELLNER ROSAN
1225 LA CIENEGA RD
SAN MARCOS, CA 92069
(
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm underpenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with,
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: C27-053License No.:. 964474
X DateZ'�%cntractor: ~
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am .exempt from the Contractor's State License Law, for the -
following reason (Seo. 7031.5; Business and Professions Code: Any city or county that requires a permit to
construct;.alter, improve, demolis'R or repair any structure, prior to its issuance, also requires the applicant for the
permit to -file a signed statement that heor she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing, with Section 7000) of Division 3 of the Business and Professions Code) or
that -he or she is exempvtherefrom and the basis for the alleged exemption. Any'violation of. Section 7031.5 by
any applicant for a permit subjects the applicant to a civil.penalty of not more than five hundred dollars ($500).:
1 _ 1 1; as owner of.the property,'ormy employees with wages as their sole compensation, will -do the work, and
the structure.is not intended or offered for sale (Sec. 7044 ;Business and Professions Code: The
Contractors' State License Law does not apply .to an owner.of property who builds,or improves thereon;
and who does -the work himself or herself,through his or her.own employees, pr6vided that the
improvements are not intended or offered for sale.- If,'however, the building or improvement is sold within
one year -of completion,.the.owne.r-builder�will have the burden of proving that heor she did not build or
improve for the purpose of.sale.)'.
(_) 1, as owner of the property, am exclusively contracting with licensed. contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors', State License Law does not apply to.an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.). ,.
(_ 1 I am exempt under Sec: I` " - ' B:&P.C.%r this reason
Date: Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPERMIT
Contractor:
DESERT OUTDOORS INC
78065,°MAIN STS -TE #205
LA,QUINTA, CA 92253
(760)359-9600
Lic..No.: 964474
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty.of.perjury one.of the following declarations:
I have and will maintain a certificate 'of consent to self -insure for workers''compensation, as provided
for by�Section 3700 of the Labor. Code, for the performance of the'work for.which this permit is
t/issued. s'
1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
insurancecarrierand policy number are: -
Carrier AMTRUST INS CO Policy Number. WWC3.072369
I certify that in the performance of the work for which this'permit is issued, I shall not employ any
person in any manner so beco subject to the workers' compensation laws -of California,
and,agree.that, if I should eco aub to the workers compensation provisions of -Section
3700 of the Labor Code, o h l�comply with those provisions.
pate:O W -A (Applicant:
E WORKER OMPENSATION COVERAGE IS UNLAWFUL-, AND SHALL
WARNING: FAILURE,TO S�Cu
SUBJECT AN EMPLOYER TO IMINAL P ALTIES AND�CIVIL FINES. UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN AD TION TO HE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3708"OF THE LABR. OODE,- TEREST, AND ATTORNEY'S FEES: v.{ • e
APPLICANT ACKNOWLEDGEMENT -
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth application.
1 . Each person upon whose behalf this application is made, each person at whose request and for
whose benefiNwork'is'performed iuider-or pursuant to any permit issued`as a -result of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or.following:issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation. '
I certify that I have read this application and state that the abo e i for at �nis correct. I agree to comply with all
city and county ordinances and state laws relating to building c tru do hereby authorize representatives
of this county enhter upon the above-mentioned property for ' spe ion ses.
Date�'�• 'Signature (Applicant or Age
Application Number . . . . . 14-00000122
Permit . . . POOL 2013
Additional desc .
Permit Fee . . . . 178.75 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date . . 8/09/14
Qty Unit Charge Per
Extension
1.00 178.7500 EA MISC POOL/SPA
178.75
----------------------------------------------------------------------------
Special Notes and Comments
POOL AT REAR YARD [DENISE POELTLER
ENGINEERING] THIS PERMIT DOES NOT
INCLUDE POOL OR EQUIPMENT ENCLOSURE.
ALARMS AND BARRIERS REQUIRED TO BE
INSTALLED AT PRE -PLASTER INSPECTION.
2013 CALIFORNIA BUILDING CODE.
February 10, 2014 4:24:13 PM AORTEGA
-- --------------- ----------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
PLAN CHECK, POOL
97.24
Fee summary Charged Paid Credited
---------------------------
Due
------------------------------
Permit Fee Total 178.75 .00 .00
178.75
Plan Check Total .00 .00 .00
.00
Other Fee Total 98.24 .00 .00
98.24
Grand Total 276.99 .00 .00
276.99
LQPERMIT
Nil #
.0ov .Of- 4 Qitlhta
BuIkOja Safety Division
P. -O. Box 1504,78-495 Caffe Tampfco
La.Quinta, CA 92253 ---(760) 777-7012
Building Permit -Application and Tracking Sheet
Permit #
Project Address: ' �7 �
'Owner's Name:. Q
A P. Number
Address: v .
Legal Description:
City, ST, Zip: L; OA.
Contractor. '`
-
II
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Address: 6
Project Description:
City, ST, Zip: tib
C., g2
L
.
Telephone: �-S
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Slate Lic #:
City Lic. f1;
Arch , EnSr., Designer:
Address:
City., ST, Zip:
Telephone:
State Lie. #: LQ
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair
Demo
Name of Contact Person:
Sq. Ft.:
# Stories: # Units:
Telephone # of Contact Person:
'?
Estimated Value of Project
APPLICANT: DO NOT WM'E BELOW THIS UNE
N
Submittal
Req'd
Recd
TRACKING
PERNPP FEES•
Pian Sets
Plan Check submitted
Item
Amount
Strgctnraf Calcs
Reviewed, ready for corrections
Phu Check Deposit. .
Truss Calcs.
Called Contact Person
Plaa,Check Balance.
Tide 24 Calm
Plans picked up
'Construction
Flood plain plan
Pians resubmitted..
Mechanical
Grading plan
2id Review, ready for corrections/issue
Electrical
Subeontaetor last
Called Contact Person
Plumbing
Grant Deed
flans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOLE:-
'o° Review', ready for correcti e
eveloper Impact Pee
Planning Approval
Called Contact Person PlAw
tA.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
lto I�Qlq
499
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SCALE: V _ V
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